TRANSCRIPT EPISODE 71 – All About Pregnancy & Birth With Dr. Nicole C. Rankins

Transcript episode #71: Rachel's Birth Story - Giving Birth In New York During COVID-19

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(00:00):

This is another great birth story episode about giving birth during the COVID-19 pandemic.

(00:12):

Welcome to the All About Pregnancy & Birth podcast. I'm Dr. Nicole Calloway Rankins, a practicing board certified OB GYN who's had the privilege of helping hundreds of moms bring their babies into this world. I'm here to help you be knowledgeable, prepared, confident, and empowered to have a beautiful pregnancy and birth. Quick note, this podcast is for educational purposes only, and is not a substitute for medical advice. Check out the full disclaimer at www.ncrcoaching.com/disclaimer. Now let's get to it.

(00:51):

Hello and welcome to another episode of the podcast. This is episode number 71. Thank you for being here with me today. Before we get into the episode, I need to take a moment and address something. At the time I'm recording this introduction, there is a tremendous amount of unrest in the United States because of the murder of George Floyd and the awakening it has caused that racism is alive, well and thriving in this country. For black people, myself included the prevalence of racism is nothing new. As will Smith said in 2016, "racism, isn't getting worse. It's getting filmed." I want to be clear that racism in the US is not limited to just police brutality. It's a systemic problem that permeates the entire criminal justice system, the educational system, and of course our health system. My passion and purpose is to serve all pregnant women. But I have always tried to be intentional about making sure I address the needs of black mamas, because the truth is they need that extra attention.

(02:18):

Because of racism, black women are at an increased risk of adverse pregnancy and birth outcomes across the board. So I will double down when serving black mamas, as I continue to keep serving all of you. Now in the background of this unrest, women are still having babies in there is still a pandemic. So let's talk about Rachel's birth story. Rachel shares her birth story of giving birth during this pandemic and doing so in a hot spot area, New York City. Rachel is originally from Southern Connecticut. She graduated from Boston university and she's lived in New York for 12 years. She and her husband of five years live in Brooklyn Heights with their brand new baby Max and their two dogs, Charlie and Chewie. Rachel is the head of accounts and production at the Feed Feed a media company that is one of the world's largest crowd sourced food publications. Now at the time Rachel gave birth things were changing literally minute to minute. And her story is just a truly incredible testament to the strength of women. So I know that you are going to learn a lot and really enjoy Rachel's story. So without further ado, let's get into Rachel's birth story.

(04:10):

Nicole: Thank you so much, Rachel, for agreeing to come on to the podcast. I know we had to reschedule this a couple of times because of various things, including what happened with you postpartum. So we're going to get into all of that and then how your labor and birth and pregnancy were affected by COVID. So I'm super excited to have you on.

(04:29):

Rachel: Yes. Thank you so much for having me. I'm really looking forward to chatting today.

(04:33):

Nicole: Yeah. So why don't you start off by telling us a bit about yourself and your family?

(04:38):

Rachel: Definitely. I live in Brooklyn, New York with my husband, our now five week old son Max, and our two dogs, Charlie and Chewy. I'm originally from Connecticut. My husband's from Maryland and we've been married for five years this August and together for almost 11.

(04:55):

Nicole: Oh, wow. Okay. Oh, I don't know how I always appreciate women who can come on right when they have a newborn baby. I don't know how you're like halfway awake to do this. So thank you for recording with me.

(05:12):

Rachel: Yes. And thank you to my husband who is hanging out with our baby right now.

(05:16):

Nicole: Good, good, good. Right. So let's hop into, because in order to understand the birth, I think we have to understand a bit about the pregnancy and prenatal care. So what was that like for you? Did you see a physician and midwife? How did you feel about the care and then how did things change once COVID happened?

(05:33):

Rachel: Sure. I've been seeing the same OB GYN in New York City where I live for about 12 years since I moved here. And the practice has a couple OB GYN and a midwife, and I just absolutely love my doctor. I find her so smart and kind and direct. So I knew that when I got pregnant that I really wanted to keep her as my doctor. She delivers in a hospital in Manhattan and I live in Brooklyn. So, you know, there were some thoughts in the beginning about how far apart those two things were. It didn't make sense, but again, just because I really loved her style and we had such a great relationship, I knew that I wanted to stay with her. And so I would call my pregnancy, you know, easy is a hard word to use because you know, nothing's ever easy with pregnancy, but it, you know, things went really well for me and I felt really good and there really weren't any complications in the beginning.

(06:25):

Rachel: So, you know, I was 34 when I got pregnant and would be 35 at delivery. So they use that, that fun term, advanced maternal age, disrespectful, but yeah, and I had my monthly appointments, you know, the weight and the blood pressure and the fetal heartbeat and blood work. And then I had monthly ultrasounds as well. And I would say overall, the care was really great. My doctor, you know, small, super busy, she always stayed with me as long as it took to answer every question I had and I'm what she calls an information junkie. So I definitely had a lot of questions. And then as the weeks went on, I found out that the baby actually had renal pylectasis, which is dilation of the renal pelvis, and you know, isn't a huge concern because very often it ends up resolving during pregnancy.

(07:11):

Rachel: And if not during then soon after birth. But it was something that made them want to continue with really regular ultrasound appointments. So I was having every month, at least one OB GYN appointment and at least one ultrasound. And as soon as we entered the month of March, I would say that's really when things started to feel different. I specifically remember an appointment where, you know, my husband and I walked in and we knew things were starting to change because of COVID and they just made him immediately leave as soon as we got there. And...

(07:43):

Nicole: Oh, wow.

(07:43):

Racherl: There wasn't a lot of explanation at that time. It was just still so early on. It was probably the first two weeks of March. And so he had to go wait in the car and it was just a really strange feeling. I ended up FaceTiming him into the appointment so that he could hear the baby's heartbeat, but, you know, there was just a lot of uncertainty at that time with him being sent out of the practice and us not having a lot of answers about everything that was happening, I would say that was really the first point where we felt like something felt really different.

(08:11):

Nicole: Yeah. And then by that point, how close were you to delivery? So how many appointments did you have left?

(08:17):

Rachel: I had probably about seven. My due date was April 13th. And so I, this was probably the second week of March. So I still have had seven more OB GYN appointments and seven more ultrasounds. And then the week after that, I knew that my husband couldn't come with me to the ultrasound. And they actually told me at that point that I wouldn't have anymore, that that would be my last ultrasound and that they didn't think it made sense for me to keep coming for them because the baby was healthy and I was healthy and that I would just continue with only the OB GYN appointment.

(08:48):

Nicole: Got it. Got it. Okay. Wow. So you still, did they switch any of the OB GYN appointments to virtual?

(08:55):

Rachel: They did. I ended up having the last few that I was supposed to have of the OB GYN appointments, so they didn't switch any of those to virtual at that point.

(09:03):

Nicole: Okay. Okay. Okay. And then was there discussion about how things were going to change in the hospital as a result of COVID? When did all of that talk start to come up?

(09:15):

Rachel: Yeah, that, that was a really interesting time. Cause I would say that was when things just started changing faster than we could keep up with. You know, we had heard the first thing that we heard was that there would be no visitors allowed at the hospital. And this was sometime in the middle of March that we started hearing rumblings of this in New York. So no visitors in the hospital, which was, I would say pretty disappointing for us. We definitely wanted to have our families thereafter to meet the baby. So, you know, we tried to take that in stride, cause we knew that there were people very sick in the hospital that couldn't have visitors. So it felt like, you know, something we could deal with on our end because it just wasn't as bad as some other people were experiencing. We tried to keep that in stride for sure.

(09:52):

Rachel: And then after that, I would say maybe a couple days later we learned, I actually worked with a birth doula and we found out she couldn't come with us to the hospital. So that was a little concerning, knowing that that was developing so quickly and we had been working with her and, you know, going through all the motions of a labor with her, so learning that she wouldn't be able to join us. Just made me a little bit apprehensive about how the labor would go because we had been working with her since I got pregnant.

(10:17):

Nicole: Sure, sure. And then was there ever any discussion at the hospital where you were planning to deliver? Because I know New York for a short time, they weren't allowing anybody in the hospitals.

(10:28):

Rachel: Yes, yes, definitely. So I think it was March 23rd was the day that we learned that no partners would be allowed at our hospital. So I was giving birth at Mount Sinai West. And that was one of the hospitals that you were not allowed to have a partner. And we, I guess had just feared that that would happen, but it, because it hadn't, we tried to take it day by day and, you know, think about how we would handle it if it came up and you don't ever imagine that something like that's actually going to happen. And I was still at that point about three weeks from delivery. So, you know, it did happen. We immediately, I would say my reaction was I was very upset and disappointed and scared to be honest because I had imagined a doula and my husband and all of a sudden I was facing giving birth by myself.

(11:14):

Nicole: I can't even imagine how you felt in that moment. I think I would probably be terrified.

(11:21):

Rachel: Yeah. Yeah. It was, it was very scary. And I would, I would say that I kind of went through the full range of emotions that you could imagine feeling at that time where immediately you feel scared and disappointed and upset, and then you feel kind of this wave of, okay, I don't have a choice in this. This is how it has to be. I have to be brave. I have to be strong. I would say my husband and I kind of went through the whole practice of, should we travel out of state? Should we go to where my family is in Connecticut and look at giving birth in one of those hospitals. And there was just kind of a whole lot of questions that raised with, do they make you go through the emergency room and will they even accept you? And does it make sense with your insurance?

(12:00):

Rachel: So it just, it kind of was a day to day. Things were changing. We were trying to decide what was best for us. And ultimately we just ended up feeling like staying with our hospital, with our doctor with as much known as we could control was what would make the most sense for us. And we spent the five, there were five days before the executive order came in, allowing a birth partner where we really thought this was what was happening with our birth plan, where we thought we would, I would be going by myself to the hospital and having this baby by myself.

(12:28):

Nicole: Right, right. Oh my goodness. Did you ever think about home birth at all?

(12:32):

Rachel: I did. It definitely crossed my mind because it's an option that's out there, but after speaking with my doula and my doctor, it just felt like something that wasn't the safest option for us. It was not something that I had been preparing for. Me being again, advanced maternal age, I had hoped to have an epidural at some point. So it just, you know, when all is said and done, the circumstances that I was expecting at the hospital just wouldn't have made sense for a home birth, but I know a lot of women that went that route and changed their plan from a hospital to a home birth because of the pandemic.

(13:02):

Nicole: Gotcha. Gotcha. So you talked about how you had prepared in part for your birth by having a doula. What other things had you done to prepare?

(13:13):

Rachel: Definitely. I absolutely listened to your podcast. Every single episode from the beginning, used your free birth guides and your Facebook community is also just such a wonderful positive place for women to kind of learn from each other. So I was really happy to join that group as well. So definitely all of that. And then I also joined the birth smarter community and it's a great community. It's an educational community as well. And, she actually, they started a group of parents that were all due in April to help support each other. So we were kind of all actually speaking to each other at the time where we thought we couldn't have partners and just kind of helping each other through it, which was really nice. I talked to a lot of my mom friends and family members asked a ton of questions, tried to stay off the internet as much as possible, just looking things up randomly. And then yeah, the doula. And then I read all of Emily Oldsters books. I love Expecting Better and Crib Sheet. Those were really helpful and just, you know, information based, learning about how to approach the whole situation.

(14:13):

Nicole: Yeah. So you did obviously lots of preparing. What were some things that you wanted for your birth? I know you said you wanted the doula there, obviously. What were some other things that you wanted?

(14:24):

Rachel: I had hoped to labor at home, which I know would have come with going into labor naturally. So just to limit my time in the hospital, and that was even, I would say before the pandemic, I just really wanted to be home as long as I could possibly be, avoid potential interventions and then wait to receive an epidural until I felt like it was truly necessary. I always knew it was something I would probably want at some point, but just to try to stick it out as long as I could before I got it. And definitely to deliver vaginally more so for the recovery, just definitely, you know, wanted to see if I could avoid having a C-section. I knew that it wouldn't make sense to get too attached to a birth plan. Of course, you know, it isn't something you can plan for, but I of course did have preferences. And I would say just ultimately the most important thing was my health and the baby's health. So I was just willing to be flexible, whatever would come.

(15:12):

Nicole: Yup. Yup. Of course, of course. And then did you doula come up with any alternative ways? Did she, you know, say we can try virtual or anything like that on the phone or video?

(15:24):

Rachel: She did. She pivoted pretty quickly to that. She had been, she had come to our apartment about two weeks before everything happened to do a really long session talking through all my preferences. And this was again, of course, before everything happened. And looking back, it's kind of funny to think, you know, our focus was on who would come and visit us at the hospital, what delivery food would we get after the baby was born? Just things that looking back you're like, how was I even focused on such crazy details like that? When so many bigger things ended up happening, but none of us could see it.

(15:56):

Nicole: I don't think any of us could see that it was coming like this. I thought it was going to be like a month or two sort of thing and we're done. This is going to be around for months. So, you know, I don't think we could have seen it coming.

(16:07):

Rachel: I think we all did. And our doula ended up doing a couple virtual sessions with us. She taught us both how to advocate for ourselves in the hospital and had a separate session with my husband, kind of teaching him some of the things that she had planned to do in the hospital. She had us get a birth ball and a peanut, which is kind of like a, more of a bulbous ball with two ends that you can put your leg over while you're in labor. So she had us get ready with all of those things and with all the information about all of the different interventions and yeah, definitely offered herself virtually. Said, you know, I will be with you the entire labor. You can FaceTime me at any time. You can call me at any time, any questions you have. So she definitely supported us really amazingly, virtually.

(16:51):

Nicole: I was going to say, she sounds amazing. Like, has she been doing this for a while?

(16:56):

Rachel: Yes. She's been doing it for awhile. She fantastic. She came recommended through a friend, and I have to say, you know, I didn't fully understand what a doula was before I was pregnant. A friend asked me if I was going to have one. And I said, you know, I don't think so. I'm not having a home birth. So I don't really think a doula is necessary. And the more women I talk to, I think that is a big misconception is what a doula actually is and what they do. And in finding out that it's really someone who is your advocate, who helps you translate all of the different things happening at the hospital and with the doctor, and really is just there to help you and serve you and make sure you have the labor that you imagine as much as possible. When I learned that that's actually what to do a little was I was all for it, but I definitely did not have any understanding of that going into being pregnant.

(17:40):

Nicole: Yeah. I think a lot of people don't don't understand. And honestly, I didn't either. And like when, Keisha, who's the community manager for the groups and she's like, no, we start working with clients early in their pregnancy, if we can. I was like, Oh really? I just thought they kind of showed up to the hospital or worked with people towards the end, but it's an ongoing thing. And it's, it's amazing.

(18:02):

Rachel: Yeah. Nice. They can, she does, it can support you postpartum and, you know, talk to you about how you're feeling and help you get connected with lactation consultants. If they don't do that themselves. And her partner actually is a lactation consultant at the hospital where I had the baby, so I got to see her. So it really is just such an amazing resource. And I would encourage anyone that you know, is questioning whether they want to have one to look into. It really was very beneficial for us.

(18:25):

Nicole: Awesome. Awesome. So let's talk about then your labor and birth. So what was that like?

(18:33):

Rachel: Sure. So I hadn't initially wanted to be induced, and had wanted to let labor happen naturally. So I could be home for as long as possible as I had said, my due date came and went and when I went to the doctor and they checked me, I was not dilated at all. So we discussed the options and she basically said, why don't we let it go a few days and see how you progress? Which I really didn't. So we started talking about induction and by that point, knowing that things were changing so frequently at the hospital kind of day to day, it felt like getting a date on the calendar that I knew I would go into labor felt comforting to me. So I completely reconsidered and decided that induction was the best choice for us. And they had been telling me kind of ongoing that it was a big baby. So I didn't really want to let it go much past that mostly for that reason. So it just felt like having the known of the date was comforting for us. So we ended up scheduling that.

(19:26):

Nicole: Okay. How far past your due date were you for your scheduled induction?

(19:30):

Rachel: Exactly one week.

(19:31):

Nicole: Okay. Okay. Yeah. And that's what I used to recommend for women. Like at a week we start the, the risk of stillbirth starts to increase 41 weeks or 41 weeks in a day. Something like that. Did your doctor pressure you at all to induce before then? Or was she pretty flexible about it?

(19:47):

Rachel: Not at all. She really asked me what I preferred and I said, I thought, you know, let's look at some dates that are a week out after the due date. And she totally supported that. So there was really no pressure from her on that.

(19:59):

Nicole: That's great to hear. Cause a lot of doctors are not like that, unfortunately.

(20:05):

Rachel: So we knew with the induction was that since we had that date in the calendar that 24 hours before that they would test us both for COVID before we were allowed to go into the hospital.

(20:14):

Nicole: Okay. Got it. So you got tested like right at the last minute, I guess. And then did the results come like, did they say you have to wait for the results to come back? Or how did that work?

(20:25):

Rachel: Yeah, they gave us the test the morning that I was to be induced and it was an, I think an eight hour turnaround. So they actually wanted us to come to the hospital at midnight. They just said that that would be the calmest time. There's the least people. And they could get us all set up for the room at that point. So it was the morning before we got the results a couple hours before we left for the hospital, obviously both negative, thankfully, and then we went in at midnight that night knowing that we were both negative.

(20:50):

Nicole: Okay. Okay. And then what was your induction like?

(20:54):

Rachel: Yeah, so we had kind of packed and repacked our bags for weeks and, like I said, received the results and got in the car, drove to the hospital and we did get there to a completely empty lobby. It was an entrance fully separate from the emergency room. I felt like it was really quiet and calm. The nurses took our temperatures, asked us some questions and then I had to go upstairs alone to be fully admitted until my husband could come join me. I went into triage. It was again, completely empty, had some paperwork to fill out. I didn't see a single other patient, only doctors and nurses. And once I was in the room, I got a gown to change into, you know, they sent me up with all the monitors and then my husband was able to come up and we were actually reminiscing about it a little bit today that it was about an hour and a half where he was downstairs and I was upstairs.

(21:41):

Rachel: And I think it was on both of our minds, just that we were separate and we were both nervous and you know, it was a scary, just a scary time to be in a hospital. And, you know, it felt like time went by so slowly where they could have just said to me, you know, he can't come up, it could have happened. And it was just something that was on both of our minds and we were both fearful of, so I just remember him walking into the room, you know, a little bit after one in the morning and just feeling so relieved. And so like I could do this and I was ready to go because he was there and it just really makes my heart go out to the women that did this without their partners, because it is just such a calming sense of comfort to have your partner there.

(22:18):

Nicole: Yeah, for sure. For sure. So then what methods did they use for the induction? How long did it take?

(22:25):

Rachel: Yeah, at that point I was, surprisingly, still not dilated at all. So we started with the Foley bulb, which they inflated inside my cervix to assist with the dilation. And then they started giving me Pitocin. And I would say from there it was pretty slow going. It took a bit of time, a couple hours to reach the four centimeters dilation before the balloon falls out. I found parts of that process more painful than I had imagined. I hadn't gotten the epidural yet. So I'm just feeling all of that process. They kind of come in and, you know, tug on the bulb and tape it to your leg. And it just felt a lot of pain, but we were on the line with my doula and she was encouraging me, you know, if this ends up going slowly, like it might, you don't want to be in bed for, you know, many, many hours. So let's try to hold off on the epidural, try to get up, bounce on the ball, move around if you can, and then we'll consider the epidural a little bit later. So I was, I was pretty adamant that I wait to get that epidural.

(23:20):

Nicole: Okay. Okay. So then how did your, the rest of your labor and delivery go?

(23:30):

Rachel: Yeah, so the Pitocin finally really started to work and the contractions started to get stronger. So about, I would say 12 or 13 hours in my water still hadn't broken. So the doctor explained she'd do an exam and then break my water. And I knew that I wanted to get the epidural as that happened. Cause I had heard that contractions start to intensify when your water breaks. So the anesthesiologist came and was kind of ready to go. As soon as the doctor did the exam and my water actually broke during the exam and I immediately felt the contractions intensify. So I got the epidural right at that point and it did provide relief so that I was grateful for that.

(24:06):

Nicole: Okay, good. And how was the staff during all of this time in terms of being supportive and attentive to your needs?

(24:14):

Rachel: The staff was amazing. They were really attentive, really helpful, just keeping really positive. They took great care of us. I was overall, I would say very happy with the care I received. The mood in the maternity ward was still joyful, which was really nice. But the PPE that they wore was kind of a constant reminder of what was happening elsewhere in the same building. And I knew, you know, that they, the hospital did also have positive COVID patients in the maternity ward. So that was just always in the back of your mind that it's happening. But, the nurses, I would say overall were really joyful. And one thing I thought was so amazing at the hospital was we started hearing bits and pieces of here comes the sun, the song. And I had thought in my head, I was like, well, maybe that's because the baby has been born, but actually was every time a positive COVID patient was released from the hospital. They played that song. So that really was so emotional and touching to hear throughout the time that we were at the hospital.

(25:06):

Nicole: Yeah. That is, that is really nice. Really nice. So you're 12 hours and you get the epidural. So then from there, how long until delivery?

(25:16):

Rachel: Yeah, so it was probably about another 20 hours and it was a very long labor. I hadn't mentioned that before. It was, it was quite long. So I feel like those 20 hours happened in slow motion because I was mostly feeling pretty comfortable. I wasn't progressing very quickly, but the epidural made me comfortable. We slept as much as we could. We watched some TV, FaceTime my parents. And then a couple of times my epidural actually wore off, which was something I didn't realize could happen. I knew my own doctor was actually coming on at 7:00 AM on the next morning. So I had thought, there's no way I'd still be in labor at that point. But, I was, so I finally, you know, the dilation started happening more rapidly and I was fairly comfortable and right up until I ended up having to start pushing the pain really wasn't there.

(26:03):

Rachel: And then all of a sudden, my back started to hurt. I started feeling pain in my groin and it seemed as if the epidural had worn off again. So I knew that I wanted to get a little bit more of it before pushing, which they actually advised me against. But I really felt like it was necessary for me to get the strength to push. So I insisted on getting the last bit of epidural. They gave that to me and then I started pushing. So it was after 33 hours that I started pushing.

(26:27):

Nicole: Yeah. You didn't mention that part.

(26:30):

Rachel: Yeah, it was, it was that long. It was, it was long all in all. I mean I put, I then pushed for three hours and can't really sugar coat. That part of it, I found that pretty painful. The pain that I had in my groin and my lower back intensified and even with all the prep that I did before, there are elements that I found surprising. Like I had to hold up my own size, which I wasn't aware happened. And my husband and a nurse held my legs and I had to hold my breath while I was pushing. You know, you can prepare as much as you want, but when you're in the moment, there are things that are still going to probably surprise you.

(27:02):

Rachel: It was pretty exhausting, but you know, the baby's head started coming out early and stayed that way for a while. And she, my doctor was really confident that I would be able to deliver the baby vaginally. So I had that reminder and, you know, confirmation in my head that really helped push me through it because I just knew that that was how I wanted the birth to go. There are definitely moments where you're so tired and you don't think it's something you're gonna be able to do, but all in all, it took three hours of pushing three incredibly long hours, but you know, as soon as he came out and they put him on my chest, it, you kind of forget all the pain that you felt and you're just so happy and relieved. And it means everything to just have your baby on your chest after he's born.

(27:39):

Nicole: Absolutely. Absolutely. Well, do you feel like during all that time, cause it must've been a long time that your water was broken too. Was there any rush or pressure from the staff? Okay, things need to get moving. That kind of thing at all?

(27:54):

Rachel: Not really. There was one point where right before my doctor did a check, she said, you know, I just want to prepare you. Things are moving a little bit slowly. There's of course, a chance that you would have to have a C section, but let's do a check. She never scared me about it. She just said she wanted me to be informed of all the possibilities that could come up. So she did the check and she was so happy when she did the exam. Cause she said, you know, it looks like things are really progressing better. And I think you're gonna be able to do this vaginally. And I think the big factor that I also didn't mention that kind of had a lot of effect on all of these elements of the labor is that the baby was nine pounds, 12 ounces.

(28:29):

Nicole: Dang.

(28:32):

Rachel: I was as surprised as you are. They had been telling me he was big the whole time and we were taking bets as a family. And every time my family would say, you know, eight pounds, 12 ounces, I was like, Oh God, I hope not. So when they took him and weighed him and I saw that pop up on the scale, I mean, I about fell out of bed.

(28:49):

Nicole: I know you had to be shocked. You were like, did I just push that human being out of my body?

(28:54):

Rachel: Yeah, it was, it was insane. It was absolutely the most surreal feeling, but it just made sense the whole way they've been telling me he was big. The pushing took a long time. The labor progressed slowly, just all kind of made sense when I saw how big he was.

(29:07):

Nicole: Oh my goodness. And then how do you feel like the staff, your nurse was helping you with the coaching during push-in and what about your husband?

(29:17):

Rachel: Everyone was great. I had the same nurse, my husband and my doctor were. And then another doctor came in and out who were all so supportive and encouraging and just kept telling me I could do it. My doctor has a very calming demeanor, so she kind of just stood there and very calmly told me that she knew I could do it. And then the nurse and my husband were both kind of in each ear cause they were holding my legs, just encouraging me. So having that support system, that team cheering you on is really, really helpful as you go through the labor. Cause it definitely gets exhausting and you just kind of need some cheerleaders.

(29:47):

Nicole: Yeah, for sure. For sure. So with that big baby, do you mind me asking, did you have any tears? Did you have to get stitches?

(29:55):

Rachel: I did have to get stitches. My doctor told me that I tore kind of right at the end. So she did give me a couple of stitches, but it really wasn't too bad or as bad as you would think it might be with a baby that big.

(30:06):

Nicole: That baby is not wearing any newborn clothes at all, I'm sure you found out.

(30:06):

Rachel: Yep. Yeah, exactly. Oh my goodness.

(30:18):

Nicole: So they put himm on your chest and did they do a delayed cord clamping?

(30:24):

Rachel: Yes. Delayed cord clamping was actually something I learned about from your podcast, and had asked my doctor about it and she, and she recommended it as well. So we did that. I did immediate skin to skin and some early breastfeeding and then my husband did skin to skin because at that point in the hospital, he actually had to leave two hours after the baby was born.

(30:45):

Nicole: Oh.

(30:46):

Rachel: So it was really important to us that he get to spend those two hours doing skin to skin with the baby before he would have to leave.

(30:52):

Nicole: So he couldn't stay for your postpartum course?

(30:55):

Rachel: He could not. There were a couple of weeks there where that was the case before they changed that as well, it was actually the week after he was born, they started letting doulas again and they let the partner stay postpartum. So we missed that by a week, but I just, I felt so grateful that he was able to be there for the birth that I was just so happy for the women that got to have their partners there the whole time. It didn't even, I didn't even feel anything other than that.

(31:17):

Nicole: Right, right. Right. And then how was your postpartum course in the hospital?

(31:22):

Rachel: It was not too bad. So like I said, he did the skin to skin and then he left and they moved me into the postpartum room and the baby and I just kind of spent the next 24 hours recovering, sleeping. He had a bunch of tests done. They tested him again for the renal pylectasis and it had actually gone away when he was born. So I was really grateful for that. I met with some lactation consultants and spent a lot of time just kind of FaceTiming Patrick and my parents. And I feel like the time went by pretty quickly and they asked me if I wanted to be discharged the next day. And I told them I did cause I just, I was really anxious to get home and thankfully didn't have complications that made it so that I'd have to stay longer. So I did tell them I wanted it to be discharged the next day. So the time went by fast and I kind of just tried to look at it as special bonding time for the baby and I to be alone.

(32:06):

Nicole: Oh, gotcha. That was a nice way to look at it. Try to look on the bright side of things. So before we talk about your postpartum course, how do you feel about the birth experience part?

(32:17):

Rachel: I feel pretty positively about it. I think there weren't a lot of things that happened that COVID negatively impacted in my opinion, other than you know, him not being able to stay, which as we just discussed, wasn't really viewed as a negative. So it still felt so joyful and so encouraging and the staff was wonderful and overall I would say it was a really positive experience for us.

(32:39):

Nicole: Okay. Awesome. I'm glad to hear that. Yeah. Yeah. So let's talk about what happened postpartum because you had a postpartum complications. So what happened with that?

(32:51):

Rachel: Sure. So because again of the size of the baby, the first couple of days, they want to monitor and make sure that the baby doesn't lose too much weight. So we had a pediatrician appointment the day after he was born and we went and his weight was down a little bit. And you know, the pediatrician encouraged me to just keep trying to feed him the colostrum because my milk hadn't come in yet. So he wanted us to come back the next day when we went back the second day, his weight had actually dropped pretty significantly more than a pound, which is they want to, I think, look for 10% of the body weight, to not go over that.

(33:23):

Rachel: And he had, so it was a little bit scary. So the pediatrician recommended that we supplement with formula since my milk wasn't in yet just to make sure that we get the baby's weight back in the positive direction. So we started doing that and I was still really trying to breastfeed him as much as I could just to get used to that. And just because he was such a big baby, I believe that his latch was just really strong, and I was having difficulty with it. I think one of the biggest negatives about the pandemic for my postpartum was that I couldn't have a lactation consultant come to the house after the baby was born. So I think that could have potentially made a big difference for me in just understanding the latch and understanding all the different elements of breastfeeding, that I didn't fully wrap my head around.

(34:07):

Rachel: So a couple of days later, you know, after he was weighed again and we found that his weight was back trending positive, which was great from the formula and from the breastfeeding, um, I started feeling really feverish and I had aches and chills and that was really concerning because those are obviously also the symptoms of COVID that was pretty terrifying, but my right breast was really red and inflamed and very painful. So I learned pretty quickly talking to the lactation consultant and doing some digging on my own that it was potentially a clogged duct or potentially even mastitis. So I worked through the symptoms of that, got in touch with my doctor immediately and she confirmed with all the symptoms that I had, that she believed it was mastitis. So she prescribed an antibiotic that I started taking right away and all of the flu symptoms went away immediately with the antibiotics.

(34:59):

Rachel: So the fever went down and the aches and chills were gone, but my right breast was still really inflamed and painful. So it really took, you know, I would say up until only a little while ago, which was about three full weeks for every symptom to go away, I had, you know, the redness and the pain and, you know, the hardness in my breasts, I had to work through that with warm compresses and continue on the course of the antibiotics for 10 days. And it really was just a slow road and really painful to breastfeed. So I started pumping pretty early but it just, it felt like, you know, one thing after another and with the trouble I had had with breastfeeding, it just got really frustrating upsetting. But you know, ultimately the most important thing to me was that the baby was fed and happy and growing. And I tried to work through all of the difficulties I was having on my own without feeling like I was doing anything wrong for the baby. It just to show important to me that he'd be fed.

(35:55):

Nicole: Right, right, right. That's a lot to work through in a short period of time.

(36:01):

Rachel: Yeah. Without the physical support of someone, I mean, my husband was amazing and so helpful during that time. And so encouraging and, you know, was getting all the warm compresses and taking care of the baby as much as possible and just really was so helpful throughout that, but not having the lactation consultant, able to be there with me, helping me through it or, you know, going to the doctor or anything like that. Just trying to avoid exposure. I think that made it a bit more difficult to deal with just having to deal with it on our own.

(36:28):

Nicole: Gotcha. Yeah, for sure. Do you ever feel like you had any bouts with sadness, depression, anxiety, any of that?

(36:36):

Rachel: It definitely made me feel anxious. But I, you know, I don't think it got to the point of depression. It just was, it was hard. It was definitely hard. I leaned on the support of mom friends who had been through it. You know, I went to one friend who knows a lot about lactation and she had mastitis five times and the more women I talked to, the more I found out just how common it was, how many people had gone through it, how they had worked through it. So that was really helpful. I think having a network and a community of people that you can lean on and have support you during hard times makes it a lot more bearable. So that was really, my approach was just talking. And then the group I mentioned earlier of the April parents, one of the other women said that she had the same thing. So I think really in just relating to other people, going through similar things or had that had been through it before really helps lift you up and makes you realize that you're doing the best you can for your baby. You're the best mom you can be for your baby. And you just have to, you know, really get yourself healthy in order to take the best care that you can have your child.

(37:38):

Nicole: Absolutely. 100%. Are you still breastfeeding or pumping?

(37:43):

Rachel: Yeah, kind of a combination of everything. I think eats way more than most babies of his age because of his size. So we are doing formula supplementing on pumping and on breastfeeding just cause he is eating constantly. So we're just giving him as much breast milk as possible, but it definitely isn't enough to sustain him for the whole day. So he has a little bit of everything going on.

(38:03):

Nicole: Okay. Okay. Yeah. It can be a challenge, especially when they eat all the time. Like you just ate, like how are you still hungry?

(38:13):

Rachel: It definitely is challenging. And I feel like, again, the more people you talk to, you learn that it's really a learning process and something that you constantly improve at. And it really, you can't get hard on yourself because it's just, it's hard. It's really hard. And everybody, you know, most people find it hard and you just push through it and it ends up everything ends up being okay.

(38:32):

Nicole: Yeah. I always call breastfeeding a labor love, you know, you definitely, you do the work because you love your children. So, but it's labor it's work. So have you had a postpartum visit yet with your doctor?

(38:46):

Rachel: I did end up going to her during the mastitis, which was about two and a half weeks after labor, but I did not have any exam other than checking out the symptoms of the mastitis. So I did not, I'm not having a postpartum visit. And then she also said that the six week could be virtual if I'm feeling okay. So they were encouraging virtual visit.

(39:06):

Nicole: Gotcha. Gotcha. Okay. Okay. So now that you're five weeks out and things are getting set, how are you feeling about everything?

(39:15):

Rachel: I feel great. Things are feeling like they're settling into a little bit more of a routine. We feel like we have his sleep figured out a little bit. So, you know, getting into that routine is definitely difficult in the beginning, but overall, I mean, I just look at him and it makes everything worth it. So I feel pretty great about everything at this point. Now that I'm feeling better physically.

(39:34):

Nicole: Yeah. That's that's great. And then how do you think you and your husband have just coped with all of these ups and downs that you've experienced in really a short period of time? And so much of it was like unpredictable and happening so fast.

(39:48):

Rachel: Yeah. It's such a good question. I think that we really let ourselves feel everything that we were going through. We talked about everything. We day by day, we came up with different plans for all the different scenarios because you really couldn't make a plan other than that day. I couldn't say, you know, if I go into labor in a week, here's what we'll do could, because we had no idea what the situation at the hospital would be. So each day we would kind of take a nice social distance walk in our neighborhood and come up with what our plan would be for what was happening that day with the hospital. So it just helped make sure that we were prepared. And then the next day something would change and we'd come up with a new plan. So I think just talking about everything was really how we coped with it, finding others that were going through the same thing for support, that was super helpful. And I'm, I mean, I'm not going to lie. There were a lot of tears, you know, I would wake up and just feel so scared or disappointed or frustrated that things were being taken away from us that you just, we just let ourselves feel everything. And I think that was really important not to keep it in.

(40:45):

Nicole: Ah, I love that. That's excellent. Excellent advice for sure. So what are your plans? Are you going to be going back to work eventually?

(40:55):

Rachel: Yeah, I worked for a food media company and before the pandemic, my job was partially remote. So, I would only go to our office space a couple of days a week and then work from home the rest of the time. So I am planning to go back to work, in early July. And as of right now, my entire company is remote and has been since middle of March. So it really is just going to be logging back on and getting engaged back with the company, which I'm looking forward to doing definitely, but excited that it's also another five or six weeks away from now. So yeah, definitely plan to go back to work, but it'll be from home.

(41:30):

Nicole: Okay. Well that's nice. You don't have to have the added stress of childcare on top of everything else.

(41:36):

Rachel: Yeah. That's a really interesting element because we had planned on putting him into daycare in July. The daycare is obviously closed now. We don't know when it will be open and lovely. A side effect of being in New York is we were on a waiting list for the last nine months that we haven't actually come off of yet. So we wouldn't even know if he had a spot in the daycare. So that's definitely an interesting element of all. This is just figuring out what, what we would do. You know, if I did have to start going back or we needed care for him.

(42:04):

Nicole: Yeah, yeah, yeah. Okay. So let's end with what would be your one piece of favorite advice that you would give to other women who are going to be giving birth during this pandemic?

(42:18):

Rachel: I think the biggest thing for me is just to say that you can do it. You're actually stronger than, you know, when faced with a situation that isn't what you imagined or it doesn't live up to your expectations that you can absolutely do it. And really just to seek out the support of others going through this, what I've found, you know, on Instagram, on Facebook, I've just kind of posted little bits and pieces of my experience. And I've had people reach out to me just with questions or just wanting to connect and talk about it. So I would obviously offer myself for that, but also just, I would just encourage everyone to just reach out to people going through this or people who have gone through this and just try to find some support and talk about how you're feeling and just know that you're stronger than you know.

(43:00):

Nicole: I love that. I love that. So where can women connect with you if they want to? I know you said you're in my Facebook group. Are you on social media publicly at all? I mean, if you're not, it's totally fine. I just offer it to everybody.

(43:13):

Rachel: Yeah, definitely. Definitely in the Facebook group, I'm also, I would say on Instagram, if they want to, it's @rachbarb on Instagram or Rachel Givens in the Facebook group. I'd be happy to connect, answer questions, just be there for support however I can help.

(43:31):

Nicole: Awesome. I love that. Well, thank you so much, Rachel, for agreeing to come on, this was really helpful. I know lots of women are going to find it helpful and you have a great voice as well. I don't know if I said that already.

(43:44):

Rachel: Thank you, as to you, you're very calming. Thanks. Thanks. Yeah. Thank you so much. This was great.

(43:49):

Nicole: Good. So glad you enjoyed it.

(43:58):

Now wasn't that a great episode? I really enjoyed speaking with Rachel and she has a lovely calming voice. Now, you know, after every episode, when I have a guest on, I do something called Nicole's notes where I talk about my top three or four takeaways from the episode. So here are Nicole's notes from my episode with Rachel. Number one, women are so freaking strong. Okay. I know it was not ideal at all, or any way, shape or form for women to give birth by themselves for those few days that they had to, or that women were suddenly faced with not having their doula or their mom present or all of the support people that they wanted to have present there, but man women are strong and they figure out how to endure. And I just think Rachel's birth story is an incredible testament to that. And shout out to all the women and all of the strength and courage and tenacity that you've shown for those of you that had to give birth alone or are giving birth, not under ideal circumstances.

(45:11):

Number two, the flexibility that Rachel and her husband showed was just key, how they really took things moment by moment, day by day, sometimes minute by minute, in terms of figuring out how they were going to proceed. That same level of flexibility is what you need to have during your pregnancy, labor and birth, regardless of when you are giving birth, birth is an unpredictable process and things can change from moment to moment. So of course you can have wishes for your birth. You should, this is an incredibly special event and occasion that doesn't happen very often in a woman's life. But as I've said before, and I'll continue to say it's really important that you're prepared for the unpredictability of birth and you're flexible. And you'll go with the flow of the process.

(46:11):

Now, one of the ways that is important to help you be able to maintain that flexibility and go with the flow of birth is good, comprehensive childbirth education. And I happen to have an amazing option. My online childbirth education class, The Birth Preparation Course ensures you are knowledgeable, prepared, confident, and empowered to have a beautiful birth. It covers everything you need, mindset, support, all the details of labor. Some of those possible things may happen, that postpartum period. It's a fantastic resource, and a course that I'm grateful to say that women truly love and truly find helpful. Right now it is deeply discounted and will continue to stay that way for the foreseeable future to make sure it's accessible to most women. So you can check out all the details of the course at www.ncrcoaching.com/enroll.

(47:13):

All right, so that's it for this episode of the podcast. Please subscribe to the podcast in Apple podcast or Spotify or wherever you hear my voice right now, it helps the show to grow. It helps other women find this show and those reviews in Apple podcast in particular are super helpful. So if you don't mind just leave those honest words for me, I super-duper appreciate it. And on a future episode, I may give you a shout out. Also do check out my free Facebook group, All About Pregnancy and Birth. It is a great group on Facebook, great group of supportive women, totally free, where you can connect with other pregnant mamas in a judgment free zone. Many women have said that it's just a nice environment and place to be to get your questions answered, bring up topics, all that good, great stuff. And I'm in the group as well. The community manager is a doula Keisha. She's amazing too. So you can find that group on Facebook at All About Pregnancy and Birth. And the link is also in the show notes.

(48:12):

Now next week on the podcast, I actually am not sure what I'm going to talk about yet. I've been doing a little rearranging of the schedule and at the time I'm recording this, I have not decided what's going to be on the podcast next week, but whatever it is, you know, it's going to be great. So do come on back next week. And until then, I wish you a beautiful pregnancy and birth.

(48:39):

Thanks so much for listening to this episode of the All About Pregnancy and Birth podcast. Head to my website at www.ncrcoaching.com to get even more great info, including free downloadable resources on how to manage pain and labor and warning signs to look out for after birth. You'll also find information on my free online class, on how to make a birth plan, as well as everything you need to know about The Birth Preparation Course. Again, that's www.ncrcoaching.com and I will see you next week.

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